In October of last year, Irma Lopez Aurelio arrived at a state health clinic in Oaxaca, Mexico, in labor with her third child. The doctors at the clinic told her to come back, that her labor was not advanced enough and no doctor was available to help her. Irma, who is indigenous, spoke little Spanish and was unable to communicate how advanced her labor was to the monolingual doctors. After hours of waiting, Irma gave birth on the lawn outside of the clinic.
In the past nine months, seven indigenous women in Mexico have been documented having their babies in the yard, waiting rooms, or front steps of state clinics. The vast majority have occurred in Oaxaca, the third poorest state, with the largest indigenous population in the country. These are some of Mexico’s most marginalized people, women who are economically, linguistically, and racially disenfranchised. In spite of repeated cases, the Mexican government has only recently taken notice of the phenomenon, after local citizens used camera phones to publish videos and photos of these human rights violations to social media.
The government’s response has taken the traditional tact: condemning what they describe as individual cases of mismanagement. Oaxaca’s Health Secretary German Tenorio Vasconcelos has fired four physicians and declared a “zero tolerance” policy for such infractions. This, of course will not address the systematic problems that bar indigenous women from accessing the reproductive health care they need.
In order to understand these cases, it is important to contextualize them within a framework that is larger than discrimination from one individual against another. The state of reproductive justice for indigenous women in Mexico speaks to a larger history of colonization, during which indigenous people were enslaved, and women were raped as a weapon of war.
Today, indigenous people are one of the poorest groups in Mexico. Chiapas, the Mexican state with the most concentrated indigenous population is the poorest state in Mexico, in spite of being home to some of the country’s richest natural resources. Indigenous women tend to have very limited access to education, and are less likely to speak Spanish than indigenous men. Because of this, over half of the 50 Oaxacan women who died in childbirth in the year 2011 were indigenous. Out of every 100 pregnant women in Oaxaca, 15 will give birth without trained medical attention.
According to Tim Johnson at McClatchy DC, these human rights violations are also caused by changes in Mexico’s health care system:
“After a 1983 constitutional amendment gave every Mexican the legal right to health care, state governments began to react. By the early 2000s, eager to reduce maternal mortality rates that were nearly double the national average, Oaxaca mandated that all pregnant women should give birth in health clinics or hospitals.”
Many state clinics are overcrowded with patients.
Many state clinics are overcrowded with patients. (Image credit: Urban DF)
Though well-intentioned, this law mandated a change that the Mexican medical system could not support, overwhelming public hospitals and clinics with patients. Situations like these create incentives for doctors to perform unnecessary cesareans and tend to detract from the value that traditional midwives and indigenous medicine can provide in birthing. Because of this system, indigenous women are often forced to travel long distances to reach over-crowded hospitals where they receive low-quality care.
The state of reproductive health care access for indigenous women in Mexico is not that different from that of indigenous communities in the U.S. Indigenous women living here face similar barriers to access. However, across the Americas, they are organizing in exciting and creative ways to push back against sexism the legacy of colonialism.
In the U.S. and Canada, the Native Youth Sexual Health Network tackles reproductive injustices from all angles, promoting culturally appropriate safe sex education, pushing for environmental justice, and fighting for the rights of youth in custody, jail or prison. Just this week they launched their Community Engagement Guide for the film Young Lakota, about a young indigenous woman fighting for reproductive justice in her community.
In Mexico, organizations like Nueve Lunas are redefining how people can give birth by working to provide Oaxacan women with birth services that respect their autonomy and value indigenous culture and knowledge. Part of this effort includes training young men and women as parteras (midwives).
Reproductive justice means understanding the history and societal context that shape an individual or community’s access to the care they need. In the case of these indigenous Mexican women, it’s not just about a few racist doctors or nurses who sent them away. It’s about a system that is failing them, one that has been in place for too long. It’s time to create a new system.